Abstract

The pathological basis for some low back pain may be due to internally disrupted intervertebral discs and in particular, sensitized annular tears. Besides surgical interventions like total disc excision and arthrodesis, percutaneous intradiscal therapies may also be considered. These intradiscal techniques are 1. annuloplasty a. intradiscal electrothermal therapy (IDET) b. Radiofrequency posterior annuloplasty (RFA) c. Biaculoplasty 2. Percutaneous disc decompression a. Laser discectomy b. Radiofrequency coblation c. Mechanical disc decompression (decompressor) d. Manual percutaneous lumbar discectomy (PLD) 3. Endoscopic percutaneous discectomy. Most of these intradiscal therapies are in application more than a decade and long tem follow ups with each technique are emerging in the literature. These therapies attempt to reduce pain rather than repair the degenerated disc. Despite anecdotal statements of success, long term results thus far have found their use to be of little direct benefit. In this lecture , long term results of these techniques will be presented and discussed.

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